I СЪЕЗД
детских анестезиологов
-
реаниматологов
Республики Узбекистан с международным участием
51
EVALUATION OF TACTICAL SURGERY BY TRANSESOPHAGEAL
ECHOCARDIOGRAPHY IN PATIENTS WITH CONGENITAL HEART
DEFECTS
Jalilov G.M., Yusupalieva G.A., Xolmuxamedov B.M., Mirzaxmedova D.M.
National Children
’
s Medical Center, Tashkent, Uzbekistan
Introduction.
Congenital heart defects are one of the leading causes of
infant mortality and are the leading cause of infant morbidity, disability and
mortality in the following countries. In terms of prevalence, congenital heart
defects in children, compared to other congenital malformations, retain leading
positions in the world and represent the most important historical and global
problem. Despite the enormous achievements in the surgery of congenital heart
defects, intra- and postoperative areas in children continue to remain a clinical
problem. Today, according to the concept of cardiac surgery safety, one of the
methods for assessing the state of blood circulation, valve function, identifying
akinesia and dyskinesia zones during cardiac surgery, as well as in the
resuscitation period is transesophageal echocardiography.
The Society of Cardiovascular Anesthesiologists (SCA) and the American
Society of Echocardiography (ASE) published a first set of guidelines for the
performance of a comprehensive intraoperative TEE exam in 1999. The aim of
these guidelines was to define a standard examination for the purposes of
training, consistency, storage, and quality. These guidelines contain a set of
twenty TEE views that were primarily designed for intraoperative use although
they have been widely adopted outside of the operating room. These guidelines
were updated in 2013 to now include an expanded 28 standard views as well as
3-dimensional imaging. In addition, a set of basic perioperative TEE guidelines
were also published in 2013 that included 11 standard views. The SCA and the
ASE realized that the availability and use of TEE as a monitoring and diagnostic
rescue tool outside of cardiac surgery had dramatically increased. Therefore, a
basic set of guidelines that were intended for use in general operating rooms by
non-cardiac anesthesiologists were developed.
Purpose.
confirmation of the correctness of the diagnosis made before the
operation. determining the direction of operational tactics.
Methods.
We analyzed the data of the transesophageal echocardiography
method in the surgical and early postoperative period in children operated on for
congenital heart defects. The study included children operated on between
2023 and 2024 at the National Children
’
s Medical Center. We analyzed
626 operations involving 620 patients with an average age of 10.2 (0.07
–
428.8)
months and an average weight of 7.1 (2
–
192) kg at the time of the intervention.
I СЪЕЗД
детских анестезиологов
-
реаниматологов
Республики Узбекистан с международным участием
52
Results.
As a result of the conducted studies, it was revealed that in
21 patients residual damage led to immediate re-intervention. Severe right
ventricular outflow tract obstruction was observed in 3 patients. Severe aortic
regurgitation was noted in 3 patients, superior vena cava stenosis in 2, moderate
residual ventricular septal defect (n = 2); severe mitral regurgitation (n = 1);
severe mitral stenosis (n = 1). Three neonates had ventilation difficulties caused
by the need to remove the transesophageal echocardiography probe, without
complications. The use of transesophageal echocardiography can significantly
improve the effectiveness of surgical intervention, providing a high degree of
visualization of cardiac structures in real time, which contributes to more
accurate decision-making in the operating room. TEE is a key tool in pediatric
cardiac surgery, providing continuous intraoperative monitoring of cardiac
structures and function. Comparative evaluation of preoperative and
postoperative echocardiographic data allows surgeons to accurately assess the
quality of the intervention performed, as well as promptly identify and correct
possible complications.
Conclusions
.
Thus, transesophageal echocardiography is an important
method for intraoperative assessment in children with congenital heart defects.
Its use improves surgical outcomes and reduces the risk of postoperative
complications, making it an indispensable tool in the arsenal of a pediatric cardiac
surgeon.
References:
1.
Абидова, З. М., Ш. Ш. Шорахмедов, and Д. Алимжанов. "Изучение
клинической эффективности шампуня кетоконазола."
Успехи медицинской
микологии
11 (2013): 121-123.
